ABSTRACT Data regarding COVID-19 infection in patients with common variable immunodeficiency (CVID) are limited. Herein, we present a 28-year-old male patient with CVID admitted for intravenous immunoglobulin (IVIG) replacement with myalgia and a productive cough. A nasopharyngeal swab for the SARS CoV-2 polymerase chain reaction assay was positive. Chest computed tomography was consistent with COVID-19 pneumonia. The patient refused hospitalization and the applicable treatment for COVID-19. Although he was prescribed IVIG, he had a lapse in IVIG replacement due to supply problems. The patient was later brought to the emergency room due to the deterioration of his general condition with dyspnea, tachypnea, shortness of breath, cough, and fever five days after the initial presentation. He was treated with favipiravir and IVIG and had a positive outcome. Results of COVID-19 infection in CVID patients are diverse, possibly due to underlying genetic defects. Although our patient had an increased risk for severe disease due to CVID, a lapse in IVIG replacement, and obesity, he did not require intensive care or intubation. Further studies are needed to determine and develop treatment strategies for COVID-19 infection in patients diagnosed with CVID. Keywords: COVID-19, common variable immunodeficiency disorders, immunodeficiencies, immunoglobulin, convalescent plasma
{"title":"COVID-19 Infection in a Patient with Common Variable Immunodeficiency: Experience with Favipiravir and Intravenous Immunoglobulin","authors":"E. Emre, G. Tazegul","doi":"10.21911/aai.618","DOIUrl":"https://doi.org/10.21911/aai.618","url":null,"abstract":"ABSTRACT Data regarding COVID-19 infection in patients with common variable immunodeficiency (CVID) are limited. Herein, we present a 28-year-old male patient with CVID admitted for intravenous immunoglobulin (IVIG) replacement with myalgia and a productive cough. A nasopharyngeal swab for the SARS CoV-2 polymerase chain reaction assay was positive. Chest computed tomography was consistent with COVID-19 pneumonia. The patient refused hospitalization and the applicable treatment for COVID-19. Although he was prescribed IVIG, he had a lapse in IVIG replacement due to supply problems. The patient was later brought to the emergency room due to the deterioration of his general condition with dyspnea, tachypnea, shortness of breath, cough, and fever five days after the initial presentation. He was treated with favipiravir and IVIG and had a positive outcome. Results of COVID-19 infection in CVID patients are diverse, possibly due to underlying genetic defects. Although our patient had an increased risk for severe disease due to CVID, a lapse in IVIG replacement, and obesity, he did not require intensive care or intubation. Further studies are needed to determine and develop treatment strategies for COVID-19 infection in patients diagnosed with CVID. Keywords: COVID-19, common variable immunodeficiency disorders, immunodeficiencies, immunoglobulin, convalescent plasma","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42105434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İ. Kalkan, G. Buhari, H. Ateş, Buket Başa Akdoğan, Özlem Özdedeoğlu, K. Aksu, F. Erkekol
Objective: Guidelines suggest using bronchial provocation testing (BPT), which is hard to attain, in patients with asthma-like symptoms presenting with nondiagnostic spirometric tests. To eliminate the risk of over/underdiagnosing asthma, we aimed to evaluate the predictive value of not only fractional exhaled nitric oxide (FeNO) but also other easily accessible clinical indices for ruling in/out asthma. Materials and Methods: This retrospective study included adults presenting to our clinic with respiratory symptoms suggestive of asthma but with normal spirometric values and negative reversibility test, who underwent FeNO and methacholine BPT (MchBPT). Medical records were used to obtain descriptive characteristics, clinical history, allergy screening, eosinophils in peripheral blood, and spirometry. Results: Among 51 patients, 19 were diagnosed with asthma. Body mass index and blood eosinophils were significantly higher in patients with positive MchBPT (p=0.042 and p=0.037, respectively). No significant difference was found in other indices, including FeNO (p=0.293). Receiver operating characteristic curve analysis revealed the best diagnostic cutoff level for FeNO as 14 ppb and blood eosinophil as 150/μl for the prediction of positive MchBPT (with 63.16%-62.5% and 80%-61% sensitivity-specificity, respectively). These two indices were the only independent predictors of positive BHR, and the model of FeNO>14ppb combined with eos>150/μl showed 100% specificity with a 100% negative predictive value. Conclusion: Our results suggest using the combination of FeNO with blood eosinophil count as a rule-out test, adding a new step in the algorithmic diagnosis of asthma. This might avoid an unnecessary BPT procedure, reduce the risk of over/under-diagnosis of asthma, and hasten the correct diagnosis.
{"title":"Can Fractional Exhaled Nitric Oxide with Blood Eosinophil Count Have a Place in the Diagnostic Algorithm for Asthma?","authors":"İ. Kalkan, G. Buhari, H. Ateş, Buket Başa Akdoğan, Özlem Özdedeoğlu, K. Aksu, F. Erkekol","doi":"10.21911/aai.643","DOIUrl":"https://doi.org/10.21911/aai.643","url":null,"abstract":"Objective: Guidelines suggest using bronchial provocation testing (BPT), which is hard to attain, in patients with asthma-like symptoms presenting with nondiagnostic spirometric tests. To eliminate the risk of over/underdiagnosing asthma, we aimed to evaluate the predictive value of not only fractional exhaled nitric oxide (FeNO) but also other easily accessible clinical indices for ruling in/out asthma. Materials and Methods: This retrospective study included adults presenting to our clinic with respiratory symptoms suggestive of asthma but with normal spirometric values and negative reversibility test, who underwent FeNO and methacholine BPT (MchBPT). Medical records were used to obtain descriptive characteristics, clinical history, allergy screening, eosinophils in peripheral blood, and spirometry. Results: Among 51 patients, 19 were diagnosed with asthma. Body mass index and blood eosinophils were significantly higher in patients with positive MchBPT (p=0.042 and p=0.037, respectively). No significant difference was found in other indices, including FeNO (p=0.293). Receiver operating characteristic curve analysis revealed the best diagnostic cutoff level for FeNO as 14 ppb and blood eosinophil as 150/μl for the prediction of positive MchBPT (with 63.16%-62.5% and 80%-61% sensitivity-specificity, respectively). These two indices were the only independent predictors of positive BHR, and the model of FeNO>14ppb combined with eos>150/μl showed 100% specificity with a 100% negative predictive value. Conclusion: Our results suggest using the combination of FeNO with blood eosinophil count as a rule-out test, adding a new step in the algorithmic diagnosis of asthma. This might avoid an unnecessary BPT procedure, reduce the risk of over/under-diagnosis of asthma, and hasten the correct diagnosis.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47661945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatih Çölkesen, Oğuzhan Kılınçel, M. Sözen, Eray Yıldız, Ş. Beyaz, Fatma Çölkesen, G. Aytekin, M. Koçak, Y. Alsancak, M. Araz, Ş. Arslan
ABSTRACT Objective: The effect of the COVID-19 pandemic on mental health in the long term is unclear. We evaluated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–related transmission fear and mental-health disorders in populations at high risk for COVID-19. Materials and Methods: Healthcare workers and patients with primary immunodeficiency disorders (PIDs), severe asthma, malignancy, cardiovascular disease, hypertension, and diabetes mellitus were included in the study. The hospital anxiety and depression scale (HADS) and Fear of Illness and Virus Evaluation (FIVE) scales were applied during face-to-face interviews. Results: There was a total of 560 participants, 80 per group; 306 (55%) were female. The FIVE and HADS-A scale scores of health care workers were significantly higher than the other groups (p = 0.001 and 0.006). The second-highest scores were in patients with PID. There was no significant difference between the groups in HADS-D scores (p = 0.07). There was a significant positive correlation between FIVE scale scores and anxiety (r = 0.828; p < 0.001) and depression (r = 0.660; p < 0.001). The FIVE scale had significant discriminatory power for anxiety (AUC = 0.870, 95% confidence interval [CI] = 0.836–0.904; p < 0.0001) and depression (area under the curve = 0.760, 95% CI = 0.717–0.803; p < 0.0001). Conclusion: During the COVID-19 pandemic, mental-health disorders may develop in patients with comorbidities, especially healthcare workers. They should be referred to mental-health centers. Keywords: Asthma, COVID-19, fear of virus transmission, mental health, primary immunodeficiency
{"title":"The Impact of SARS-CoV-2 Transmission Fear and the COVID-19 Pandemic on the Mental Health of Patients with Primary Immunodeficiency Disorders and Severe Asthma, and Other High-Risk Groups","authors":"Fatih Çölkesen, Oğuzhan Kılınçel, M. Sözen, Eray Yıldız, Ş. Beyaz, Fatma Çölkesen, G. Aytekin, M. Koçak, Y. Alsancak, M. Araz, Ş. Arslan","doi":"10.21911/aai.651","DOIUrl":"https://doi.org/10.21911/aai.651","url":null,"abstract":"ABSTRACT Objective: The effect of the COVID-19 pandemic on mental health in the long term is unclear. We evaluated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–related transmission fear and mental-health disorders in populations at high risk for COVID-19. Materials and Methods: Healthcare workers and patients with primary immunodeficiency disorders (PIDs), severe asthma, malignancy, cardiovascular disease, hypertension, and diabetes mellitus were included in the study. The hospital anxiety and depression scale (HADS) and Fear of Illness and Virus Evaluation (FIVE) scales were applied during face-to-face interviews. Results: There was a total of 560 participants, 80 per group; 306 (55%) were female. The FIVE and HADS-A scale scores of health care workers were significantly higher than the other groups (p = 0.001 and 0.006). The second-highest scores were in patients with PID. There was no significant difference between the groups in HADS-D scores (p = 0.07). There was a significant positive correlation between FIVE scale scores and anxiety (r = 0.828; p < 0.001) and depression (r = 0.660; p < 0.001). The FIVE scale had significant discriminatory power for anxiety (AUC = 0.870, 95% confidence interval [CI] = 0.836–0.904; p < 0.0001) and depression (area under the curve = 0.760, 95% CI = 0.717–0.803; p < 0.0001). Conclusion: During the COVID-19 pandemic, mental-health disorders may develop in patients with comorbidities, especially healthcare workers. They should be referred to mental-health centers. Keywords: Asthma, COVID-19, fear of virus transmission, mental health, primary immunodeficiency","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44936320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Omalizumab is a safe and effective treatment option for chronic spontaneous urticaria (CSU). Although cohort studies in patients with asthma show no increased risk of congenital abnormalities, very little data exist in the literature regarding the use of omalizumab for CSU during pregnancy. Herein, the safe and successful use of omalizumab updosing in a pregnant woman with CSU along with a review of the published literature is presented. Keywords: Chronic spontaneous urticaria, omalizumab, pregnancy, updosing
{"title":"Omalizumab Treatment in Chronic Spontaneous Urticaria During Pregnancy: Report of A Case and Review of the Literature","authors":"A. Salman, Meryem Aktas","doi":"10.21911/aai.599","DOIUrl":"https://doi.org/10.21911/aai.599","url":null,"abstract":"ABSTRACT Omalizumab is a safe and effective treatment option for chronic spontaneous urticaria (CSU). Although cohort studies in patients with asthma show no increased risk of congenital abnormalities, very little data exist in the literature regarding the use of omalizumab for CSU during pregnancy. Herein, the safe and successful use of omalizumab updosing in a pregnant woman with CSU along with a review of the published literature is presented. Keywords: Chronic spontaneous urticaria, omalizumab, pregnancy, updosing","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46380023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez
Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.
{"title":"Risk and Outcomes of COVID-19 Patients with Asthma: A Meta-Analysis","authors":"Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez","doi":"10.21911/aai.590","DOIUrl":"https://doi.org/10.21911/aai.590","url":null,"abstract":"Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46507691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Çakmak, S. B. Kaya, Ö. Bostan, G. Tuncay, E. Damadoğlu, G. Karakaya, A. Kalyoncu
Coronavirus disease 2019 (COVID-19) originated in Wuhan, China, and caused a pandemic in the world SARS-CoV-2 infections have a great health risk, especially in patients with chronic diseases There are concerns that COVID-19 will be more severe in patients with severe asthma The efficacy and safety of biological agents used in severe asthmatics during SARS-CoV-2 infections are currently unknown In this case report, we present a patient who had been using omalizumab for five years with the diagnosis of severe asthma and died due to COVID-19 To the best of our knowledge, this is the first case of a Turkish patient who died due to COVID-19 under omalizumab treatment for severe asthma
{"title":"Mortality due to COVID-19 in a Patient with Severe Asthma Receiving Omalizumab Treatment: A Case Report","authors":"M. Çakmak, S. B. Kaya, Ö. Bostan, G. Tuncay, E. Damadoğlu, G. Karakaya, A. Kalyoncu","doi":"10.21911/aai.584","DOIUrl":"https://doi.org/10.21911/aai.584","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) originated in Wuhan, China, and caused a pandemic in the world SARS-CoV-2 infections have a great health risk, especially in patients with chronic diseases There are concerns that COVID-19 will be more severe in patients with severe asthma The efficacy and safety of biological agents used in severe asthmatics during SARS-CoV-2 infections are currently unknown In this case report, we present a patient who had been using omalizumab for five years with the diagnosis of severe asthma and died due to COVID-19 To the best of our knowledge, this is the first case of a Turkish patient who died due to COVID-19 under omalizumab treatment for severe asthma","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48203133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Öztürk, Nur Adalier, Sadi Can Sönmez, Leyla Pur Özyiğit, S. Tekin, B. Çağlayan, Ö. Ergönül
Antibiotics are the most common class of medications that patients reportedly become allergic to. The estimated rate of real antibiotic allergy varies widely in the literature (1, 2). A high number of allergic reactions are unconfirmed and often self-reported (3). Nevertheless, these patients are labeled as allergic to antibiotics. A label for antibiotic allergy in clinical settings changes the management of future infectious diseases for that patient. Infectious disease physicians have a key role in deciding the antibiotic of choice in hospitalized patients. The patient’s history of antibiotic allergy and the physicians’ knowledge of antibiotic allergy have an impact on the antibiotic management plan. It is therefore undeniable that labeling patients with an antibiotic allergy is an important issue in daily clinical practice. Antibiotic options for patients reporting an antibiotic allergy are very limited and many physicians prescribe broad-spectrum antibiotics, which may result in increased adverse events and antibiotic resistance (4). It is very important to diagnose antibiotic allergy correctly to come up with an effective treatment in suspected antibiotic allergy cases. All in all, to better understand infectious disease physicians’ management plans and knowledge of antibiotic allergies, it is important to implement a better and standardized algorithm for antibiotic allergic hospitalized patients in the future. The aim of this study was to determine the attitudes and experiences of adult / pediatric infectious disease specialists on antibiotic allergy management. Therefore, after getting approval from the local ethics committee (Koç University Ethics Committee, 2019.021.IRB2.010), a 20-item questionnaire in open-label and multiple choice formats has been developed and sent to members of The Infectious Diseases and Clinical Microbiology Society of Turkey (KLİMİK) by using the society e-mail network. Specialists included adult and pediatric infectious disease specialists across Turkey who prescribe antibiotics for 30 or more patients per year. Out of 800 KLİMİK members who meet the inclusion criteria, 124 specialists and registrars practicing as adult (95%) or pediatric (5%) infectious disease physicians have responded to the e-mail by answering questions.
抗生素是最常见的一类药物，据报道患者会对其过敏。文献中对真实抗生素过敏的估计率差异很大(1,2)。大量过敏反应未经证实，通常是自我报告(3)。然而，这些患者被标记为对抗生素过敏。临床环境中抗生素过敏的标签改变了该患者未来传染病的管理。传染病医生在决定住院患者的抗生素选择方面起着关键作用。患者的抗生素过敏史和医生的抗生素过敏知识对抗生素管理计划有影响。因此，不可否认的是，在日常临床实践中，标记抗生素过敏患者是一个重要问题。对于报告抗生素过敏的患者，抗生素的选择非常有限，许多医生开广谱抗生素，这可能导致不良事件和抗生素耐药性增加(4)。正确诊断抗生素过敏，对于可疑的抗生素过敏病例提出有效的治疗方法非常重要。总而言之，为了更好地了解传染病医生的管理计划和抗生素过敏知识，未来对抗生素过敏住院患者实施更好和标准化的算法是很重要的。本研究的目的是确定成人/儿童传染病专家对抗生素过敏管理的态度和经验。因此，在获得当地伦理委员会(Koç University ethics committee, 2019.021.IRB2.010)的批准后，我们编制了一份20个项目的问卷，采用开放标签和多项选择的形式，并通过该协会的电子邮件网络发送给土耳其传染病和临床微生物学会(KLİMİK)的成员。专家包括土耳其各地的成人和儿科传染病专家，他们每年为30名或更多患者开抗生素。在符合纳入标准的800名KLİMİK成员中，124名以成人(95%)或儿科(5%)传染病医生身份执业的专家和登记员通过回答问题回应了电子邮件。
{"title":"Antibiotic Allergy from the Perspective of Infectious Disease Physicians","authors":"A. Öztürk, Nur Adalier, Sadi Can Sönmez, Leyla Pur Özyiğit, S. Tekin, B. Çağlayan, Ö. Ergönül","doi":"10.21911/aai.571","DOIUrl":"https://doi.org/10.21911/aai.571","url":null,"abstract":"Antibiotics are the most common class of medications that patients reportedly become allergic to. The estimated rate of real antibiotic allergy varies widely in the literature (1, 2). A high number of allergic reactions are unconfirmed and often self-reported (3). Nevertheless, these patients are labeled as allergic to antibiotics. A label for antibiotic allergy in clinical settings changes the management of future infectious diseases for that patient. Infectious disease physicians have a key role in deciding the antibiotic of choice in hospitalized patients. The patient’s history of antibiotic allergy and the physicians’ knowledge of antibiotic allergy have an impact on the antibiotic management plan. It is therefore undeniable that labeling patients with an antibiotic allergy is an important issue in daily clinical practice. Antibiotic options for patients reporting an antibiotic allergy are very limited and many physicians prescribe broad-spectrum antibiotics, which may result in increased adverse events and antibiotic resistance (4). It is very important to diagnose antibiotic allergy correctly to come up with an effective treatment in suspected antibiotic allergy cases. All in all, to better understand infectious disease physicians’ management plans and knowledge of antibiotic allergies, it is important to implement a better and standardized algorithm for antibiotic allergic hospitalized patients in the future. The aim of this study was to determine the attitudes and experiences of adult / pediatric infectious disease specialists on antibiotic allergy management. Therefore, after getting approval from the local ethics committee (Koç University Ethics Committee, 2019.021.IRB2.010), a 20-item questionnaire in open-label and multiple choice formats has been developed and sent to members of The Infectious Diseases and Clinical Microbiology Society of Turkey (KLİMİK) by using the society e-mail network. Specialists included adult and pediatric infectious disease specialists across Turkey who prescribe antibiotics for 30 or more patients per year. Out of 800 KLİMİK members who meet the inclusion criteria, 124 specialists and registrars practicing as adult (95%) or pediatric (5%) infectious disease physicians have responded to the e-mail by answering questions.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46063256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus disease 2019 (COVID-19). In terms of asthma and COVID-19, there is also a risk of experiencing an asthma exacerbation triggered by coronavirus infection beyond the direct risk of the infection itself. As a comorbid disease, the prevalence of COVID-19 infection in asthma patients is not clear. In addition, the influence of asthma on the severity of COVID-19 has not been reported. The aim of this review was to summarize the reported worldwide data about the prevalence and the clinical characteristics of patients with asthma during COVID-19 infection.
{"title":"Asthma as A Comorbid Disease in COVID-19","authors":"A. Baccioglu, S. Bavbek","doi":"10.21911/AAI.565","DOIUrl":"https://doi.org/10.21911/AAI.565","url":null,"abstract":"Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus disease 2019 (COVID-19). In terms of asthma and COVID-19, there is also a risk of experiencing an asthma exacerbation triggered by coronavirus infection beyond the direct risk of the infection itself. As a comorbid disease, the prevalence of COVID-19 infection in asthma patients is not clear. In addition, the influence of asthma on the severity of COVID-19 has not been reported. The aim of this review was to summarize the reported worldwide data about the prevalence and the clinical characteristics of patients with asthma during COVID-19 infection.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42490144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
COVID-19 caused by SARS-CoV2 has spread rapidly across the world, resulting in many patients in need of intensive care support Severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis/septic shock, and multi-organ failure may occur during the disease course among many other complications There still is not a definite cure, but supportive care is important to minimize complications Patients in need of respiratory support and interventions should preferably be placed in negative pressure isolation rooms, with utmost care to decrease viral spread Points to consider during oxygen therapy, non-invasive and invasive mechanical ventilation, and shock management of COVID-19 patients are discussed Patients with mild hypoxia may be managed with conventional oxygen therapy, while others will benefit from high flow nasal oxygen therapy and mechanical ventilation Although corticosteroids are not recommended for other viral pneumonia, there are recent reports suggesting that steroids may have a place in the treatment of COVID-19 patients with hypoxia Shock may complicate the course of the disease and a search for the etiology of shock should be carefully planned Thromboembolic events are common;prophylaxis and/or treatment of thromboembolic events should be managed according to the guidelines Meanwhile, the results of ongoing randomized, controlled trials on antiviral and immunomodulatory agents are expected to offer better treatment options for COVID-19 patients in the near future
{"title":"COVID-19 and Intensive Care","authors":"L. Talan, N. D. Altıntaş","doi":"10.21911/AAI.555","DOIUrl":"https://doi.org/10.21911/AAI.555","url":null,"abstract":"COVID-19 caused by SARS-CoV2 has spread rapidly across the world, resulting in many patients in need of intensive care support Severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis/septic shock, and multi-organ failure may occur during the disease course among many other complications There still is not a definite cure, but supportive care is important to minimize complications Patients in need of respiratory support and interventions should preferably be placed in negative pressure isolation rooms, with utmost care to decrease viral spread Points to consider during oxygen therapy, non-invasive and invasive mechanical ventilation, and shock management of COVID-19 patients are discussed Patients with mild hypoxia may be managed with conventional oxygen therapy, while others will benefit from high flow nasal oxygen therapy and mechanical ventilation Although corticosteroids are not recommended for other viral pneumonia, there are recent reports suggesting that steroids may have a place in the treatment of COVID-19 patients with hypoxia Shock may complicate the course of the disease and a search for the etiology of shock should be carefully planned Thromboembolic events are common;prophylaxis and/or treatment of thromboembolic events should be managed according to the guidelines Meanwhile, the results of ongoing randomized, controlled trials on antiviral and immunomodulatory agents are expected to offer better treatment options for COVID-19 patients in the near future","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43598799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asthma is one of the most common chronic respiratory diseases in the world and there is great concern about the effect of COVID-19 infection on asthma severity and control Although the link between asthma and COVID-19 infection remains to be determined, available data indicate that asthma does not seem to be a risk factor for severe COVID-19 This review aims to summarize the updated data about the association between viral infections and asthma exacerbations including COVID infection and management of asthma flare-ups during the COVID pandemic, based on the recommended asthma guidelines
{"title":"Role of SARS-CoV-2 in Asthma Exacerbations","authors":"A. Ozturk, S. Bavbek","doi":"10.21911/AAI.560","DOIUrl":"https://doi.org/10.21911/AAI.560","url":null,"abstract":"Asthma is one of the most common chronic respiratory diseases in the world and there is great concern about the effect of COVID-19 infection on asthma severity and control Although the link between asthma and COVID-19 infection remains to be determined, available data indicate that asthma does not seem to be a risk factor for severe COVID-19 This review aims to summarize the updated data about the association between viral infections and asthma exacerbations including COVID infection and management of asthma flare-ups during the COVID pandemic, based on the recommended asthma guidelines","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45925859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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